A genotoxic carcinogen, N-nitrosodimethylamine (NDMA), was detected as a synthesis impurity in some valsartan drugs 2018, and other N-nitrosamines, such N-nitrosodiethylamine (NDEA), were later sartan products. N-nitrosamines are pro-mutagens that can react with DNA following metabolism to produce adducts, O6-alkyl-guanine. The adducts result replication miscoding errors leading GC>AT mutations...